The Dutch Diaries: Prenatal Visits

Last month I talked about the general differences in the Dutch approach to pregnancy, and how it is just a normal process in the Netherlands. But there were a few specific things that were not at all what I expected when it came to what went on during my obstetric visits.

In the first half of my pregnancy, I expected to be weighed and was perplexed when nobody asked me to climb aboard a scale. I asked my midwife if they were going to weigh me and she paused, asked if I really wanted to be weighed, then we both had a good laugh. She explained that she didn’t find monthly weight tracking to be necessary. She preferred to evaluate my progress by feeling my belly, measuring it and observing me, because bodies grow babies on a very individual basis. She found it rather silly to have a guideline of weight gain to abide by. Imagine that!

In the US, ultrasounds are done with increasing frequency – to confirm pregnancy, a growth scan, then several at the end to assess fetal size, position, fluid levels, etc, despite mounting evidence that they are somewhat unreliable and lead to unnecessary interventions. In the Netherlands, they are planned only twice. Once to confirm the pregnancy and gestation age, between 10‐12 weeks, and once for the anatomy check at 20 weeks. Sometimes, if they suspect an odd position, they will do another at 35 weeks. I have a few friends who, by choice, didn’t have any ultrasounds at all and their providers were ok with this.

And then, there was the day I asked about when to write up my birth plan. One of my favorite things about the Dutch culture is their general practical attitude about things. I figured they’d love birth plans! Birth plans are practical! At around 20 weeks pregnant, I asked my midwife when I could start writing mine. I was excited for this planning, this way to take control of the process. I wanted an unmedicated birth, immediate skin-to-skin, delayed cord clamping – all the typical requests for a gentle birth. She looked amused and again, explained gently that that in Holland, they let birth take its course. They do not intervene medically unless out of absolute necessity. They allow movements, and choice in pushing positions, depending on what feels best to the mother. The skin‐on‐skin is a necessity here and they wait on the APGAR scoring. There are not eye drops given, and no vaccinations administered. Baby goes straight to mama and is put immediately on the breast (I’ll talk more about breastfeeding next month). There is less of a protocol when it comes to birthing. They make sure baby is breathing, and then the rest takes its course and the parents gets to decide then and there how it all unfolds. Well that took all the wind out of my planning sails, but also made me feel so much more relaxed about the process.

I look forward to next month, when I discuss an amazing Dutch program called Moeders voor Moeders, or Mothers for Mothers!

~Breezy

2 thoughts on “The Dutch Diaries: Prenatal Visits

  1. I wonder what you mean by the statement that they wait for the APGAR scoring. That is simply not possible. The Apgar is an observation done at 1 and 5 minutes after birth to give the health care provider a good idea of what kind of the care the baby will need in the immediate postpartum period. It is most often rcorded without any one else knowing that the observation was made unless the baby came out flat and they had to assess the heart rwte. Either it is done, or it is not done.

    Also, there are no immunizations given at birth. The needle that is given is vitamin K, and it can be delayed for a short time, which may vary by birth setting. I woukd be interested to know if that is routinely given in Holland, if women decline or opt for oral vitamin K, or if it is given at all.

    Love hearing about your experience in Holland as I am Dutch myself and was born at home with a family physician in attendance in 1966. I am also an RN with a maternity background so it is all very fascinating to hear about the current Dutch practices. Very uplifting!
    Matthuschka Sheedy (nee van den Bosch).

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    • I believe she meant that they assess the APGAR while baby is skin to skin vs removing the baby to do so, as is common in American hospitals that do not have Baby Friendly designation.

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